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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021050
Report Date: 11/06/2024
Date Signed: 11/06/2024 02:57:04 PM

Document Has Been Signed on 11/06/2024 02:57 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:BELLA VISTA ELEMENTARYFACILITY NUMBER:
198021050
ADMINISTRATOR/
DIRECTOR:
DANIEL OROSCOFACILITY TYPE:
830
ADDRESS:2410 NORTH FINDLAY AVENUETELEPHONE:
(323) 721-4335
CITY:MONTEREY PARKSTATE: CAZIP CODE:
91754
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 8DATE:
11/06/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Lead Teacher, Martha VegaTIME VISIT/
INSPECTION COMPLETED:
03:05 PM
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On November 6, 2024, Licensing Program Analysts (LPA) Priscilla Ochoa and Licensing Program Manager (LPM) Ana Chico conducted an unannounced case management inspection for the above facility. LPA was greeted by Lead Teacher, Martha Vega. The purpose of this inspection is to conduct a file review for staff and children. Per Lead Teacher there are 8 children enrolled and LPA observed 8 children in care.

During the inspection, LPA observed three staff present. LPA was provided with two staff files which were incomplete as partial records are kept off site. LPM Chico contacted Vicky Bermudez, Program Specialist, who confirmed that a waiver to keep records off site will be requested.
LPA observed Staff 1 (S1) staff qualifications, Pediatrics first aid and CPR which expires 7/2025, and Mandated Reporter which expires 3/08/2025. Staff 2 (S2) staff qualifications and Mandated Reporter which expires 7/28/2025. Missing documentation for staff files are as follows:
- Proof of immunization of measles, pertussis and influenza
- LIC 503 Health Screen Report
- LIC 9108 Statement Acknowledging Requirement to Report Child Abuse
- LIC 9052 Employee Rights

LPA will conduct a second file review inspection at head quarters. LPA was able to review children's records which were deemed complete.

There are no deficiencies being cited at this time.

A notice of site visit was given and must remain posted for 30 days during facility’s hours of operation. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and a copy of this report was provided, along with appeal rights to Lead Teacher, Martha Vega

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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